Poor nutritional status is associated with incomplete functional recovery in elderly patients with mild traumatic brain injury

Abstract

BackgroundThe geriatric nutritional risk index (GNRI) is a simple index for evaluating the nutrition status of elderly patients. Many investigations have demonstrated that this index is associated with the prognosis of several diseases. This study aims to identify the relationship between the GNRI and recovery in elderly mild traumatic brain injury (mTBI) patients.MethodsA total of 228 mTBI patients older than 65 years were included in this study. mTBI was defined as an injury to the brain with a loss of consciousness of 30 min or less, a duration of posttraumatic amnesia of <24 h, and an admission Glasgow Coma Scale (GCS) score of 13–15. The Glasgow Outcome Scale Extended (GOSE), an outcome scale assessing functional independence, work, social activities, and personal relationships, was applied to assess the recovery of the patients. The clinical outcome was divided into complete recovery (GOSE = 8) and incomplete recovery (GOSE ≤ 7) at 6 months after the injury. Multivariate logistic regression was applied to evaluate the association between the GNRI and recovery of elderly mTBI patients, with adjustment for age, sex, hypertension, diabetes, and other important factors.ResultsThe receiver operating curve (ROC) analysis demonstrated that the cutoff value of GNRI was 97.85, and the area under the curve (AUC) was 0.860. Compared to the patients with a high GNRI, the patients with a low GNRI were older, had a higher prevalence of anemia, acute subdural hematoma, and subarachnoid hemorrhage, had a higher age-adjusted Charlson Comorbidity Index value, and had lower levels of albumin, lymphocytes, and hemoglobin. Multivariable analysis showed that high GNRI was associated with a lower risk of 6-month incomplete recovery (OR, 0.770, 95% CI: 0.709–0.837, p < 0.001).ConclusionThe GNRI has utility as part of the objective risk assessment of incomplete 6-month functional recovery in elderly patients with mTBI.

Geriatric Nutritional Risk Index has a Prognostic value for Recovery Outcomes in Elderly Patients with Brain Abscess

“…Similarly, Bao et al's study revealed that among elderly patients experiencing early neurological deterioration following acute ischemic stroke, 48.3% were at risk of malnutrition according to GNRI [26]. In another study, the GNRI assessment revealed a malnutrition risk of approximately 42.5% (97/228) among elderly patients with mild traumatic brain injury [27]. These results above suggest that brain injury in elderly patients is often accompanied by malnutrition.…”

“…A positive correlation emerged between GNRI scores and GOS scores(P < 0.001), indicating a nutritional status may be signi cantly associated with recovery and long-term outcomes in brain abscess patients. Several studies also have demonstrated a correlation between elevated malnutrition risks and adverse clinical outcomes in geriatric patients [27,31]. It can be seen that in the process of diagnosis and treatment of geriatric diseases, the assessment of nutritional status cannot be ignored.…”

“…A study focused on elderly patients with mild traumatic brain injury revealed that a higher GNRI was associated with a decreased risk of incomplete recovery at the 6-month mark. Furthermore, the ROC analysis established a GNRI threshold of 97.85 [27]. And GNRI was considered a promising tool for predicting mortality outcomes in older patients with moderate to severe TBI [22].…”

Geriatric nutritional risk index has a prognostic value for recovery outcomes in elderly patients with brain abscess

“…Similarly, Bao et al’s study revealed that among older patients experiencing early neurological deterioration following acute ischemic stroke, 48.3% were at risk of malnutrition according to GNRI ( 30 ). In another study, the GNRI assessment revealed a malnutrition risk of approximately 42.5% (97/228) among older patients with mild traumatic brain injury ( 31 ). These results above suggest that brain injury in older patients is often accompanied by malnutrition.…”

“…A positive correlation emerged between GNRI scores and GOS scores ( p < 0.001), indicating a nutritional status may be significantly associated with recovery and long-term outcomes in brain abscess patients. Several studies also have demonstrated a correlation between elevated malnutrition risks and adverse clinical outcomes in geriatric patients ( 31 , 35 ). It can be seen that in the process of diagnosis and treatment of geriatric diseases, the assessment of nutritional status cannot be ignored.…”